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Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured.
The following types of contributions and areas are considered:
1. Original articles:
Technology development in medicine: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine.
Significance of medical technology and informatics for healthcare: The appropriateness, efficacy and usefulness deriving from the application of engineering methods, devices and informatics in medicine and with respect to public health are discussed.
2. Technical notes:
Short communications on novel technical developments with relevance for clinical medicine.
3. Reviews and tutorials (upon invitation only):
Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented.
4. Minisymposia (upon invitation only):
Under the leadership of a Special Editor, controversial issues relating to healthcare are highlighted and discussed by various authors.
Abstract: BACKGROUND: Bleaching agents are commonly used in dentistry for treating the discolored teeth. A number of biomaterials and methods are in clinical applications. OBJECTIVE: The major aim of this study was to evaluate the effects of two different bleaching agents on the surface roughness properties of dental resin nanocomposites and dental porcelains using various regimes. METHODS: This study was conducted using direct restorative hybrid and nanocomposite materials and dental porcelains. The specimens were treated using the bleaching gels [(Opalescence Boost 40% OP) and (Whiteness HP 35% WHP)] for 30, 45, 60 and…120 minutes respectively. Treated samples were analyzed for surface roughness properties using contact mode surface profilometry and surface topography using scanning electron microscopy (SEM). Data was analyzed statistically using analysis of variance (ANOVA). RESULTS: There were no significant changes observed in the roughness of nanofill, nanohybrid composites and ceramic materials compared to microhybrid resin composites (p> 0.05). The SEM photomicrographs confirmed the results of the profilometer showing slight changes in the microhybrid resin composite. CONCLUSIONS: No remarkable difference was observed between the bleaching agents (Opalescence Boost and Whiteness HP Blue) for the surface roughness of tested dental materials. The bleaching agents can be used without harming the ceramic, nanofilled or nanohybrid resin restorations. However, if microhybrid or microfilled composite restorations are present in the oral cavity, bleaching may damage the surface finish and requiring replacement of restorations.
Keywords: Bleaching system, composite, dental porcelain, surface properties, SEM
Abstract: BACKGROUND: Fatigue is the most common symptom associated with cancer and its treatment, and profoundly affects all aspects of quality of life for cancer patients. It is very important to measure and manage cancer-related fatigue. Usually, the cancer-related fatigue scores, which estimate the degree of fatigue, are self-reported by cancer patients using standardized assessment tools. But most of the classical methods used for measurement of fatigue are subjective and inconvenient. OBJECTIVE: In this study, we try to establish a new method to assess cancer-related fatigue objectively and accurately by using smart bracelet. METHODS:…All patients with metastatic pancreatic cancer wore smart bracelet for recording the physical activity including step count and sleep time before and after chemotherapy. Meantime, their psychological state was assessed by completing questionnaire tables as cancer-related fatigue scores. RESULTS: Step count record by smart bracelet reflecting the physical performance dramatically decreased in the initial days of chemotherapy and recovered in the next few days. Statistical analysis showed a strong and significant correlation between self-reported cancer-related fatigue and physical performance (P= 0.000, r=-0.929). Sleep time was also significantly correlated with fatigue (P= 0.000, r= 0.723). Multiple regression analysis showed that physical performance and sleep time are significant predictors of fatigue. CONCLUSIONS: Measuring activity using smart bracelets may be an appropriate method for quantitative and objective measurement of cancer-related fatigue by using smart bracelet devices.
Abstract: BACKGROUND: A fall in elderly subjects can lead to serious psychological consequences. These symptoms can develop into Fear of Falling with behavioural disorders comparable to PTSD that may severely limit autonomy. Virtual reality training (VRT) could be seen as a worthwhile therapeutic approach for this syndrome since it has been shown to be a useful tool for motor rehabilitation or combat-related PTSD. We thus developed a training scenario for VRT with psychomotor therapists. OBJECTIVE: To test the feasibility and acceptability of VRT when used by elderly adults for fall rehabilitation.…METHODS: Our population of 8 patients older than 75 years, with a Mini Mental Score Examination greater than 18/30 performed sessions of VRT and answered a questionnaire on the feasibility and acceptability of it. RESULTS: This sample showed a highly favourable response to the prototype of VRT. They found it easy to use, enjoyed the experience, and thought it realistic and helpful. CONCLUSION: The conclusions of our study are limited by sample size. However, applications with VRT can offer the potential of an acceptable technique for elderly subjects. The next step will be to show the efficacy of this method in the management of post-fall PTSD.
Keywords: Rehabilitation, virtual reality training, psychomotor consequences of fall, elderly population
Abstract: BACKGROUND: Problem or pathological gambling has been a worldwide concern in the recent years, especially so with the advances in the technology, facilitating easier access to various means of gambling. Along with the advances in web-based and smartphone technologies, these technologies have been recently applied as adjunctive clinical tools to help gamblers. Taking into careful consideration the existing evidence base for Internet based interventions for pathological gambling, it seemed that the current published literature has demonstrated largely the efficacy of a personalized feedback intervention for pathological gambling; and further studies are still under-going to try and demonstrate the clinical…feasibility of online web-based cognitive behavioral interventions for pathological gamblers. OBJECTIVES: Given this, the aims of the current study are to (a) replicate an online personalized feedback intervention and determine its receptiveness in an Asian cohort of gamblers; and (b) to identify the demographics and characteristics of Asian gamblers who would utilize an online intervention. METHODOLOGY: The workgroup at the National Addiction Management Service, Singapore conceptualized the online personalized feedback intervention for gamblers. The English version was launched on the 31st of March 2014 and the Chinese version was launched on the 30th of September 2014. RESULTS: A cumulative total of 708 participants took part with rhe mean age of the participants being 32.70 (SD = 11.638), with 89.1% males and 10.9% females. The mean problem gambling severity score (PGSI) was 10.80 (SD = 8.13), with the vast majority participating in Casino gambling on board a cruise (36.0%). Of significance, approximately 59.2% of the participants who sought help with our online e-intervention did have a diagnosis of problem gambling. CONCLUSIONS: This is one of the first few studies to demonstrate and replicate the potential use of an Internet based intervention for non-problem and problem gamblers. The current study has demonstrated that individuals are generally receptive towards such an intervention.
Keywords: Gambling, addiction, Internet intervention, Singapore
Abstract: OBJECTIVE: Diagnosis of Parkinson's Disease (PD) by analyzing the resting tremor were much studied by using different accelerometer based methods, however the quantitative assessment of Hoehn and Yahr Scale (HYS) score with a machine learning based system has not been previously addressed. In this study, we aimed to propose a system to automatically assess the HYS score of patients with PD. METHODS: The system was evaluated and tested on a dataset containing 55 subjects where 35 of them were patients and 20 of them were healthy controls. The resting tremor data were gathered with the…3 axis accelerometer of the Nintendo Wii (Wiimote). The clinical disability of the PD was graded from 1 to 5 by the HYS and tremor was recorded twice from the more affected side in each patient and from the dominant extremity in each control for a 60 seconds period. The HYS scores were learned with Support Vector Machines (SVM) from the features of the tremor data. RESULTS: Thirty-two of the subjects with PD were classified correctly and 18 of the normal subjects were also classified correctly by our system. The system had average 0.89 accuracy rate (Range: 81-100% changing according to grading by HYS). CONCLUSIONS: We compared quantitative measurements of hand tremor in PD patients, with staging of PD based on accelerometer data gathered using the Wii sensor. Our results showed that the machine learning based system with simple features could be helpful for diagnosis of PD and estimate HYS score. We believed that this portable and easy-to-use Wii sensor measure might also be applicable in the continuous monitoring of the resting tremor with small modifications in routine clinical use.
Abstract: BACKGROUND: Most annuloplasty rings and bands used for mitral valve repair restrict annular motion due to their fixation to the posterior annulus, the commissures, and the trigones. OBJECTIVE: Annular motion was evaluated after posterior mitral annuloplasty (PMA) for correction of mitral valve regurgitation (MR) using a strip that is designed for placement in the posterior annulus only, sparing the anterior annulus and both commissural angles. METHODS: Valve annular dynamics were analyzed in 51 patients who underwent PMA for MR. In 37 patients (72.5%), additional associated procedures were performed: new chord placement…(n = 35), patch valvuloplasty (n = 4), and posterior leaflet augmentation (n = 12). Patients received serial echocardiographic follow-up. RESULTS: After PMA, the MR grade was nil or mild (0 and 1+) in 47 patients (92.1%), moderate (2+) in 3 patients (5.9%), and moderate to severe (3+) in 1 patient (2.0%). The maximum and minimum septo-lateral dimensions during the cardiac cycle were 21.7 ± 4.8 mm and 18.1 ± 4.1 mm (p < 0.0001), respectively, and the change ratios were 19.8 ± 9.3%. While the septo-lateral dimensions exhibited dynamic changes, the aorto-mitral dimensions remained constant throughout the cardiac cycle. CONCLUSIONS: PMA preserves dynamic septo-lateral motion of the mitral valve annulus during the cardiac cycle.
Abstract: This paper proposes an Oesophageal Speech (OES) enhancement method, based on Kalman filtering. The Kalman filter is applied to modulators of OES frequency subbands instead of the fullband signal. The OES frequency subbands are decomposed into modulators and carriers components using coherent demodulation. In comparison with fullband Kalman filtering and pole stabilization, the proposed technique shows better results. The system performance is evaluated objectively and subjectively using the Harmonic to Noise Ratio (HNR) and Mean Opinion Score (MOS) respectively. Results have shown that Kalman filter in subband modulators processing is robust and efficient, improving the HNR by 4 to 5…dB for all Spanish vowels.
Keywords: Alaryngeal speech, Kalman filtering, filterbank, synthesis/analysis, modulation frequency domain
Abstract: BACKGROUND: There have been some disagreements on the comparison of disc pressures in the standing and sitting postures in literature. Most research on in vivo pressure needle measurement found higher disc pressure in sitting than in standing. The disc pressure data can help to advocate better postures for clinical advice. OBJECTIVE: The aim of this paper is to develop a procedure to study the compressive load on intervertebral joint in the standing and sitting postures through the approach of motion capture and musculoskeletal modeling. METHODS: The marker data of six subjects performing…various standing and sitting postures was obtained during the motion capture experiment and used to train the musculoskeletal model with an enhanced discretized spine developed for subject in the inverse and forward simulations. RESULTS: Compressive loads on L3-L4 and L4-L5 joints are found higher in upright sitting than in upright standing. Slumped sitting, cross-legged sitting and flexion sitting can introduce higher compressive loads on intervertebral joints compared with upright sitting. CONCLUSIONS: These findings indicate the effects of standing and sitting postures on the spinal joint loads. The results can provide doctors and therapists with more information on clinical advice on better postures for people with spinal problems.
Abstract: BACKGROUND: Malnutrition in geriatric patients is very common and an important outcome factor when treating injuries and fractures. There is actually no clear definition of the term malnutrition or recommendation for a screening method. OBJECTIVE: The purpose of this study was to determine the nutritional status of geriatric trauma patients using different screening procedures. We tested whether the body mass index (BMI) gives indication for malnutrition or if there is a correlation with more specific test procedures. METHODS: The BMI and the data of three specific screening procedures, Subjective Global Assessment…(SGA), Nutritional Risk Screening (NRS) and Mini Nutritional Assessment (MNA) were calculated; clinical parameters were registered. RESULTS: There was proof of correlation (p< 0.001) between BMI and SGA; also between BMI and NRS was a significant correlation (p= 0.0004). There was less significant correlation between BMI and MNA (p= 0.05). All three screening methods correlated (p< 0.01). CONCLUSIONS: BMI and subjective statements provide first important information. The SGA not only correlates well with the BMI, but also complements the overall picture with individual information regarding medical history and clinical findings. Other more extensive methods, such as the NRS and the MNA, also show correlation and complement the overall picture with individual information.
Keywords: Geriatric patient, fracture, Subjective Global Assessment (SGA), Nutritional Risk Screening (NRS), Mini Nutritional Assessment (MNA), body mass index (BMI)
Abstract: BACKGROUND: The strength of the taper joint plays a vital role in orthopedics which takes the full load of our body. Till date various techniques has been used for the stem manufacturing and an alternative to all those has been presented in the article. OBJECTIVE: This Paper deals with the experimental analysis of the taper connection.The results of the experiment has also been validated during the experimentation process. METHODS: In case of our experimentation stems of taper joints were implemented in the hips. RESULTS: Microscopy based analysis…revealed that there was almost no damage in the stems being developed during the process of experimentation. CONCLUSIONS: As a result it could be summarized that the stem developed during the experimental process were more reliable and free from any type of fretting.